Direct Approach Care Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated Requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received person centred care because the provider ensured people were valued as individuals with diverse needs and preferences. Care records were completed in person-centred language and reflected people’s experiences. Staff worked in person-centred ways with people and were committed to supporting people to meet their needs and preferences.

We observed staff interacting respectfully with people and making positive efforts to engage with them.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Peoples’ care and support plans had been developed with input from relatives and other professionals. Though people’s health needs had been included in care plans we found inconsistent information in relation to medicines, risk assessments and risk management plans. Access to some records was difficult due to a lack of organisation, some care records were contradictory. This meant we could not be assured people received consistent care and support.

People’s placements and support levels had been reviewed with commissioners and amended as required. This helped ensure people received the right level of support.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People or their representatives did not always have access to information relevant to them or the service. Feedback from relatives indicated people often found it difficult to access basic information about people’s needs, for example up to date epilepsy monitoring charts.

People were supported by staff who understood how to communicate with them and how to support decision making. The provider ensured people’s communication needs and preferences had been assessed and communication plans developed. Care records included information and guidance for staff about the level of language and the typical phrases a person may use. Staff were also provided with guidance about what a person may mean and how to respond. There were some pictorial guides available in the home.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Feedback from stakeholders had either not been sought or, when provided, had not been recorded and responded to. The provider had a complaints policy and procedure but did not keep a log of any complaints or concerns. This meant we could not be assured people had been listened to or had any concerns addressed.

Staff we spoke with were not aware of any systems in place to provide their views and feedback.

We received some positive feedback from relatives who told us they were pleased with the service provided.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People had been supported to overcome some of the obstacles they experienced accessing equitable health services. This included support to access specialist dental treatment. Emergency protocols were in place in relation to specific medical conditions such as epilepsy, we found these were inconsistent and did not provide clear guidance to staff. There was a risk people would not receive the treatment they needed in a timely manner.

There was an on-call system for staff to contact members of the management team, out of hours, when they needed any advice in relation to urgent needs or emergencies. We were not assured all staff would make use of this.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People were supported to achieve equity in experiences and outcomes because the provider ensured inequalities they may experience were identified in care records. People’s preferences had been recorded and staff supported people to engage in their preferred activities. People had access to vehicles and drivers to support them get out and about.

Staff had received training in relation to equality and diversity.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People had been supported to plan for their future wishes and aspirations. Staff worked well with people to understand what they enjoyed and sought opportunities to develop people’s perceived ambitions. This included social activities, shopping, day trips and activities in the home.

People were supported by their families with any advanced decisions.